Protective rib and lower back pads are commonly used by athletes and other individuals in conjunction with protective shoulder pads to protect the individual's torso from impact that may result in injury. For example, protective shoulder pads, rib pads and lower back pads are utilized in sports where collision is inherent and produces a significant risk of injury, such as football, lacrosse, and hockey. The protective rib and lower back pads generally attach to the athlete's protective shoulder pads and suspend down from the protective shoulder pads.
When neck or cervical spine injuries occur, protective shoulder pads, rib pads and lower back pads themselves become a risk factor for secondary injury during the course of initial medical evaluation and management. While medical personnel provide stabilization to the wearer's spine, the protective shoulder pads and suspended rib and lower back pads must be removed from the injured athlete while the athlete is lying supine. This will help to protect the athlete from further injury and aid in the diagnosis and treatment of a suspected cervical spine or neck injury. The suspended connection of the protective rib and lower back pads to the shoulder pads provides a greater burden in the removal of the protective shoulder pads due to the weight of the individual's torso on the protective rib and lower back pads while the individual is lying supine.
Currently available protective shoulder pads, rib pads and lower back pads only allow removal as an entire unit. The proper technique for protective shoulder pad removal includes one member of the medical team maintaining manual stabilization of the athlete's head and neck at all times. While that member of the medical team remains in place manually stabilizing the head and neck, the injured athlete's torso is elevated to a 30-40 degree angle by flexing the athlete's lower spine and hips which requires at least four trained people. Alternatively, the entire athlete must be lifted which could require up to eight people. While in this compromised position, the protective shoulder pads, rib pads and lower back pads are then maneuvered in a manner to remove them, essentially, over the head and then under the body of the injured athlete. This maneuver is extremely complicated and may potentially cause a secondary injury. Research in the field of spinal cord injury has suggested up to 25% of cervical spinal cord injured patients experience neurologic deterioration during the course of initial evaluation and management.
In the event that an individual suffers a suspected injury to the spine or neck, the current practice in the medical profession is to stabilize the individual in the supine position while diagnosing and treating the individual. The National Athletic Trainers' Association's guidelines and recommendations in this field, Prehospital Care of the Spine-Injured Athlete, require that any athlete who is suspected of having a head and/or spinal injury should be managed as though a spinal injury exists, and if unconscious, the player is presumed to have an unstable fracture until it is proved otherwise. The guidelines further state that the improper management of a suspected spinal injury can result in a secondary injury. Head and shoulder stabilization must be maintained during any manipulation and removal of equipment to avoid cervical movement, lateral flexion and other movements which could lead to further injury.
While providing stabilization to the wearer's spine, the protective shoulder pads, rib pads and lower back pads must be removed from the injured athlete while lying supine to aid in the diagnosis and treatment of a suspected cervical spine or neck injury. The current National Athletic Trainers' Association's guidelines and recommendations require at least four individuals to remove currently available shoulder pads, rib pads and lower back pads. Routinely up to eight individuals may be needed to remove the currently available pads. Realizing the importance of limiting the amount of unnecessary movement during this process to prevent a secondary injury, the guidelines recommend removing the protective pads only to an extent that full access to chest, face, neck, and arms may be accessed. The National Athletic Trainers' Association's suggested method comprises the steps of cutting all soft clothing and soft portions of the shoulder pads with a knife or equivalent cutting apparatus as required to spread the two anterior halves of the protective shoulder pads that are currently available. However, the repositioning of the protective shoulder pads to this limited extent precludes sufficient access to the neck and cervical spine areas that medical personnel must access to diagnose and treat an individual with a suspected cervical spine injury.
Recent published studies by Rechtine and Horodysky at the University of Rochester have demonstrated significant motion in the cervical spine during shoulder pad removal despite the utilization of optimal techniques that are currently recommended by national athletic training and trauma specialty organizations. The consequences of such motion may include loss of one or more levels of neurologic function in the acute spinal cord injured athlete. This alone could result in a potentially ambulatory athlete becoming non-ambulatory, an independent athlete becoming dependent, or an athlete who may have independent respiration becoming respirator dependent. The human cost and the cost to society of such deterioration is enormous. No current protective shoulder pad, rib or lower back pad design allows for the safe removal of the protective pads from an individual immobilized in the supine position by less than four properly trained people. Furthermore, current protective shoulder pad, rib and lower back pad designs prevent both stabilization of the potentially injured athlete and an acceptable quality of radiographic imaging.
In their article Helmet and Shoulder Pad Removal in Football Players with Unstable Cervical Spine Injuries, M. C. Dahl, D. Ananthakrishnan, G. Nicandri, and R. P. Ching, the authors, while recognizing that “patient handling is often impaired due to the protective equipment worn and improper stabilization of these patients can exacerbate neurologic injury,” the authors discussed alternative methods for removing protective shoulder pads and the resulting detriments caused by each method. The levitation technique was found to produce motion in the anterior and right lateral directions. The tilt technique resulted in motions in the posterior left lateral directions, and the log roll technique generated motions in the right lateral direction and had the largest amount of increased instability when comparing the intact and lesioned specimen. According to the authors, “these findings suggest that each method of equipment removal displays unique weaknesses that the practitioner should take into account.”
In another study, the amount of motion that occurred during protective shoulder pad removal in a cadaver with an injured spine was evaluated and quantified. Helmet and shoulder pad removal from a player with suspected cervical spine injury. A cadaveric model. Spine. W F Donaldson, W C Lauerman, B Heil, R Blanc, T Swenson. 1998. The authors of the study concluded that shoulder pad removal in the unstable cervical spine is a complex maneuver, and that because of the motion observed in the unstable spine, shoulder pad removal should be performed in a carefully monitored setting by at least three, preferably four, trained people.
Another problem with currently available shoulder pads, rib pads and lower back pads is that different types of protective shoulder pads, rib pads and lower back pads are available for specific purposes, and the different types exacerbate the problems in removing the shoulder pads. Specific models of protective shoulder pads have posterior portions of the shoulder pads that protect down to the small of the user's back, and/or include rib pads and lower back pads. The injured athlete must be moved to a greater degree to remove the shoulder pads, thus increasing the potential for a secondary injury. The weight of the wearer's torso exerted on the posterior member of the shoulder pads and/or rib and lower back pads prevents easy removal of the shoulder pads, and as discussed, it is undesirable to move the individual wearing the protective shoulder pads. Another complication of attempting to remove protective shoulder pads over the head of an individual is the weight and mass of the individual. Large and heavy individuals are more difficult to lift and their body mass proves detrimental to the removal of the protective shoulder pads, thus requiring more movement of the individual and increasing the potential for a secondary injury in a person with a suspected neck or cervical spine injury.
Thus, existing protective shoulder pads, rib pads and lower back pads become an impediment to diagnosing and treating an individual while in the supine position and the removal of the shoulder pads, rib pads and lower back pads may potentially cause a secondary injury. The removal of the protective shoulder pads, rib pads and lower back pads requires significant movement of the wearer by at least four trained medical personnel. No protective shoulder pads, rib pads and lower back pads are available that allows for removal of the shoulder pads, rib pads and lower back pads and allows for sufficient access to the wearer's neck and spine while maintaining the neck and spine in a substantially neutral position while in the supine position. What is needed in the industry are shoulder pads, rib pads and lower back pads that allow for the safer removal of the protective shoulder pads, rib pads and lower back pads from an individual immobilized in the supine position. Furthermore, what is needed in the industry are shoulder pads, rib pads and lower back pads that promote both stabilization of the potentially injured athlete and allow an acceptable quality of radiographic imaging.
These improved protective shoulder pads, rib pads and lower back pads provide a solution to the challenges of diagnosing and treating suspected neck and spinal injuries. By allowing the removal of the shoulder pads while maintaining the neck and spine in the substantially neutral position, these improved shoulder pads, rib pads and lower back pads substantially reduce the risk of further injury to an individual wearing shoulder pads with a suspected neck or spinal injury. The benefit of these improved protective shoulder pads, rib pads and lower back pads is the ease and effectiveness of removal of those portions of the pads that typically present obstacles to the effective diagnosis and treatment.
Once these portions are removed, medical personnel can more effectively diagnose and treat the individual suspected of a cervical spine or neck injury. The release mechanism according to an embodiment of the present invention for the rib pads and lower back pads address the risk of increasing neurologic injury in the spinal cord injured athlete by reducing the spinal motion demonstrated by Rechtine during shoulder pad removal. Embodiments of the present invention provide for removal of the rib and lower back pads by a release mechanism which is easily accessible by first responders, medical professionals and others.
The novel removable protective contact sports pads according to an embodiment of the present invention provide a solution to the challenges of diagnosing and treating suspected neck and spinal injuries. By providing for the disconnection or decoupling of the protective rib and lower back pads from the protective shoulder pads while maintaining the neck and spine of the individual in the substantially neutral position, these novel detachable protective pads substantially decrease the risk of further injury to an individual wearing protective shoulder pads. Embodiments of the invention provide for detachment or decoupling of the protective rib and lower back pads from the protective shoulder pads by a release mechanism which is easily accessible by first responders, medical professionals and others while the wearer is in the supine position. An anterior portion of the release mechanism is accessed from the anterior portion of the shoulder and rib pads while the wearer is in the supine position. Once the protective rib pads and lower back pads are decoupled from the protective shoulder pads, medical personnel can more effectively remove the protective shoulder pads and diagnose and treat the individual suspected of a cervical spine or neck injury and the injured athlete's spine may be accessed for radiographic evaluation.